NPIMap

Organization Active NPI

Medicor Healthcare, Inc

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
National Provider Identifier
1740697895
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
PH26927 Issued in FL
Legal business name
MEDICOR HEALTHCARE, INC
Practice address
3403 W Waters Ave
Tampa, FL 33614-2713
Phone
(813) 930-8000
Fax
(813) 930-8026
NPI assigned
Jul 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dwight Colston
Title
Pharmacy Manager
Phone
(813) 930-8000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PH26927 FL Primary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Home Infusion Therapy Pharmacy 3336H0001X

Addresses

Primary practice location

3403 W Waters Ave
Tampa, FL 33614-2713

Mailing address

3403 W Waters Ave
Tampa, FL 33614-2713
Phone (813) 930-8000

Other identifiers 1

IdentifierTypeStateIssuer
2144161OtherPK

Other names 1

  • Medicor Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medicor Healthcare Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1740697895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 W WATERS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142713",
            "telephone_number": "813-930-8000",
            "fax_number": "813-930-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3403 W WATERS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142713",
            "telephone_number": "813-930-8000",
            "fax_number": "813-930-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICOR HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "COLSTON",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "813-930-8000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PH26927",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144161",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicor Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.